Claims Examiner

婵物捨; Kuala Lumpur; On-site; MYR 40,000 - 60,000; Full time

Job summary

A leading company in the insurance sector is seeking a Claims Specialist to manage personal and commercial line claims. The role involves documenting claims, determining liability, negotiating settlements, and ensuring compliance with regulations. Candidates are expected to have a Bachelor's degree and over 3 years of related experience. With a commitment to diversity and a focus on employee growth, this position offers a dynamic work environment in Kuala Lumpur.

Qualifications

• More than 3 years’ work experience in claim processing is advantageous.
• Ability to analyze and determine policy coverage.
• Experience in managing litigation and ensuring legal compliance.

Responsibilities

• Document claims file by accurately capturing and updating claims data.
• Assess damages and negotiate settlement of claims.
• Follow best practices to ensure quality standards are met.

Skills

Claims Processing

Liability Assessment

Negotiation

Customer Service

Education

Bachelor's Degree or equivalent in a related field

Job description

With moderate direction, handles single and multi-party personal or commercial line claims of moderate exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

Key Accountabilities

1. Document claims file by accurately capturing and updating claims data/information. Determine liability by gathering and analyzing relevant facts.
2. Analyze and determine policy coverage. Work to have a timely resolution to claims by developing case strategy, developing a case evaluation; escalating issues as appropriate.
3. Establish timely reserves and perform ongoing review throughout the claims cycle within authority limits.
4. Assess damages and negotiate settlement of claim by establishing an appropriate negotiation strategy.
5. Meet quality standards by following best practices.
6. Ensure customer service by proactively communicating information, responding to inquiries, and following customer protocols.
7. Align with the organization's Claims Vendor Management strategy.
8. Ensure legal compliance by following laws, regulations, and internal control requirements.
9. Refer claims to subrogation and fraud teams.
10. Contribute to profitable growth by providing risk insights, information, and trends to the Business Unit or customers as needed.
11. Protect Zurich's reputation by keeping claims information confidential.
12. Understand current industry trends, establish personal networks, and participate in professional societies.
13. Manage litigation by assigning counsel within the approved panel where applicable.
14. Education: Bachelor's Degree or equivalent in a related field.
15. Experience: More than 3 years’ work experience in claim processing is advantageous.

At Zurich, we are proud of our culture and passionate about Diversity and Inclusion. We encourage you to bring your whole self to work. Our initiatives create an environment where everyone feels welcome regardless of protected characteristics.

We accept applications from everyone regardless of background, beliefs, or culture. We are committed to continuous improvement and offer comprehensive training and development opportunities. Zurich supports employees in volunteering, charitable, and community activities.

Make a difference. Be challenged. Be inspired. Be supported. Love what you do. Work for us.

You are the heart & soul of Zurich!

We think outside the box and challenge the status quo with an optimistic approach, focusing on what can go right. We value our employees’ experience and offer opportunities across business areas for growth. We’re proud to be a Great Place To Work Certified organization. Our culture is our top priority! #GPTWcertified

Location: MY – Kuala Lumpur

Schedule: Full Time

Recruiter: Caroline Louis